Epinephrine - West Virginia Association of School Nurses

“Saving Lives of Students and Staff:
The New West Virginia Epinephrine
Law/Rule
Rebecca King MSN, MEd, RN, NCSN
School Nurse Liaison/504 Coordinator
WVDE-Office of Special Programs
Congratulations to
WV School Nurses
West Virginia
Status and Stats
Top 5 Medical Diagnoses/Procedures
2010/11 School Nurse Needs Assessment
Medical Diagnoses
In-School Specialized
Health Care Procedures
Asthma
Inhalers for Asthma
Behavioral Disorders
Emergency Medications
Anaphylactic Reaction
Long-Term Medications
Obesity
Special Diets per Federal Form
Mental Disorders (Depression,
Bipolar, Schizophrenic, Suicidal)
Seizure Management
Close 5th places…..
Ear, Nose and Throat/
Migraine or Severe
Headache/Seizures
Diabetes Type II
2010/11
Student Medical Diagnoses
Diabetes Type I
16145
Seizures
18000
16000
11491
14000
Anaphylactic
Reaction
12000
10000
4213
8000
6000
4000
2000
0
238
852
2147
Behavioral
Disorders/ADD/
ADHD/OCD/Anxi
ety
Asthma
WHY are increases in
Allergies occurring in WV?
•
•
•
•
Students
Environment (art material, etc.)
School programs
Etc.
System Response
to Severe Allergy
Allergen
Epinephrine
(adrenaline)
MADGE
to the RESCUE
Hypotension
Bradycardia
Immunoglobin
Vasoconstriction of
Respiratory System
E
Epinephrine/Adrenaline
Harm vs. Help
• Temporary relief due to short half-life
of 2-3 minutes for epinephrine.
• Hence a rebound effect and need to
call 9-1-1 or possibly administer
another dose.
• Restore blood pressure, heart rate and
respiratory status
States with Laws allowing
Stock Epinephrine in Schools
Objective #1:
Participants will learn
about the new W.Va.
law and WV State
Board of Education
Rule on the county
option of stock
epinephrine for
undiagnosed students
and staff.
Passage of Epinephrine Law
or W.Va. §18-5-22c
Signed by Governor with effective date of
July 8, 2013
Status of State Board
Medication Administration Policy
• Incorporated into WV State Board of
Education Rules by the WV Council of
School Nurses through WVBE Policy
2422.8-Medication Administration
• Public comment period ended on
November 12, 2013
• Request for approval will be at the
December 11-12, 2013 State Board meeting
What does this
mean to me?
County Boards have the OPTION of
Stock Epinephrine Policy
• County Boards of Education will have OPTION
to develop medication policies allowing stock
epinephrine.
• Administered under the prescription and
standing orders of a MD or DO to students
and school personnel who are experiencing
signs and symptoms of severe allergic
reactions/anaphylactic shock without prior
diagnoses.
County Boards have the OPTION
of Stock Epinephrine Policy
The training and delegation of
administering epinephrine will be done
by SCHOOL NURSES with delegation and
assignment to other nurses (registered
nurses and licensed practical nurses) and
designated qualified personnel (teachers
at will, aides and secretaries) working in
the school system.
Education and Training in
Anaphylaxis and Epinephrine
by the School Nurse(s)
Doses and Half Life
Doses:
• Epinephrine 0.15 mg for weight of
33 pounds to 66 pounds
• Epinephrine 0.3 mg for weight of
66 pounds or greater
Half Life:
The plasma half-life is about 2-3 minutes.
Concerns of Harm?
• Benefits definitely outweigh any minimal risk factors.
• Temporary relief due to short half-life of 2-3 minutes for
epinephrine.
• Hence a rebound effect and need to call 9-1-1 or possibly
administer another dose.
• Restore blood pressure, heart rate and respiratory status
Objective #2:
• Participants will
learn about the
storage and
reporting of
epinephrine use in
schools.
Storage
Schools shall maintain epinephrine
auto-injectors in a SECURE, unlocked,
location, which is only accessible to
school nurses, health care providers
and authorized nonmedical personnel
and not by students.
Reporting
West Virginia
Poison Center at
http://www.wvp
oisoncenter.org/
Default.aspx.
West Virginia Poison Center
Report each reaction resulting in the
administration of epinephrine
injections to the West Virginia Poison
Center by calling 1-800-222-1222
after emergency medical services
have transported the student or staff
member to acute care.
Poison Center
Reporting Information
The notification should include the
name of the student, the student’s age
and gender, date and the approximate
time the incident occurred, symptoms
observed, who administered the
injection, the name of the school the
student attends,…
Continued…
a contact telephone number, the
rational for administering the injection,
the response to the epinephrine
administration, the dose of epinephrine
administered and any other necessary
elements to provide a complete report
for the individual situation (templates
will be provided to schools).
Objective #3:
• Participants will be
familiar with
EpiPen4Schools
Program offered
through Mylan
Pharmaceutical.
Cost to Schools
EpiPen4Schools Program
• Go to
http://www.epipen4schools.com/
and follow the directions.
• Download order application form
for FREE EpiPens
– You will need a prescription from a
MD or DO (your designated medical
consultant)
No more than
two 2-Pak Units per school
Next steps…
• After you have completed the steps
above, BioRidge Pharma will find a
pharmacy near your school that is
able to fill the prescription and
forward a copy of your valid
prescription to the pharmacy. All
orders will be shipped directly to
your school.
NEW Auvi-Q School
Discount Program
How?
Email:
[email protected]
OR
Call: (855) 722-8847
for an application
QUESTIONS?
TOGETHER
we can save lives!
Rebecca King
WVDE-Coordinator
School Health, Section 504 and
Coordinated School-Public Health
[email protected]
304.558.8830